Chapter 2
Trends in Substance Abuse Treatment Admissions: 1995-2005

Trends in Primary Substance of Abuse
Trends in the Co-Abuse of Alcohol and Drugs
Trends in Admission Rates by Primary Substance and State
Trends in Demographic Characteristics
Trends in Socioeconomic Status

Trend data are invaluable in monitoring changing patterns in substance abuse treatment admissions. These patterns reflect underlying changes in substance abuse in the population, and have important implications for resource allocation and program planning.

Trends in Primary Substance of Abuse

Table 2.1b and Figure 1. Between 1995 and 2005, TEDS treat­ment admissions were dom­inated by five sub­stances: alcohol, opiates (primarily heroin), cocaine, marijuana, and stimulants (primarily methamphetamine). These substances together consistently accounted for between 95 and 96 percent of all TEDS admissions from 1995 to 2005.

Figure 1
Primary substance of abuse at admission:
TEDS 1995-2005

Line chart comparing Primary substance of abuse at admission in TEDS 1995 to 2005

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.3.06.


1 These drugs include methadone, codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects.

Trends in the Co-Abuse of Alcohol and Drugs

Table 2.2 and Figure 2. The concurrent abuse of alcohol and drugs continues to be a significant problem. In 2005, approximately 39 percent of all admissions reported problems with both alcohol and drugs—22 percent reported primary drug abuse with secondary alcohol abuse, and 18 percent reported primary alcohol abuse with secondary drug abuse.*

Primary alcohol abuse declined from 51 percent of TEDS admissions in 1995 to 39 percent in 2005. Primary drug abuse increased from 46 percent in 1995 to 58 percent in 2005. However, this may reflect changing priorities in the treatment/reporting system rather than a change in substance abuse patterns. Limited resources and targeted programs may result in a shift of State funds from treatment of alcohol abusers to treatment of drug abusers.

* Percentages do not sum to 39 percent because of rounding.

Figure 2
Co-abuse of alcohol and drugs at admission: TEDS 1995-2005

Stacked bar chart comparing Co-abuse of alcohol and drugs at admission in TEDS 1995 to 2005

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.3.06.

Trends in Admission Rates by Primary Substance and State

Tables 2.3b-2.8b and Figures 3-8 show trends in State admission rates per 100,000 population aged 12 and over for selected substances from 1995 to 2005.

For the maps in Figures 3-8, the median, 75th, 90th, and 99th percentiles of the range of 1995 admission rates for each substance were used to establish the rate categories used in the legend. Therefore, for the 47 States reporting in 1995, each 1995 map generally shows 1 State in purple (the 99th percentile and above), 4 States in red (the 90th to 98th percentiles), 7 States in orange (the 75th to 89th percentiles), 12 States in gold (the 50th to 74th percentiles), and 23 States in cream (below the median 1995 U.S. rate). Crosshatching indicates States where no data were submitted, or where changes in reporting patterns made inclusion in trend calculations for a given year inappropriate.

Data were not submitted for one or more years in some States or jurisdictions because of changes to their data collection systems. These States were: Alaska (2004-2005), Arizona (1995-1997), the District of Columbia (2004-2005), Indiana (1997), Kentucky (1995-1996), New Mexico (2005), West Virginia (1997-1998 and 2000), and Wyoming (1995-1996 and 2005).

In six States and jurisdictions, significant changes in the clients or facilities reported to TEDS from 1995 to 2005 resulted in changes in the number of admissions large enough to influence trends. For these States, rates are not indicated on the maps for the years affected: the District of Columbia (1995-1996), Idaho (2005), Louisiana (1997), Texas (1996), Virginia (1997-1998), and West Virginia (1996). The actual data reported, however, are included in all tables.


2Tennessee included Heroin admissions among admissions for Opiates other than heroin beginning in 1998. Therefore Tennessee is excluded from the tabulations of the number of States reporting in both 1995 and 2005.

3These drugs include codeine, hydrocodone, hydromorphone, meperidine, morphine, opium, oxycodone, pentazocine, propoxyphene, tramadol, and any other drug with morphine-like effects. Non-prescription use of methadone is not included.

Figure 3
Primary alcohol admission rates by State: TEDS 1995-2005
(per 100,000 population aged 12 and over)

Maps comparing Primary alcohol admission rates by State in TEDS 1995 to 2005 (per 100,000 population aged 12 and over)

 

 

Figure 4
Primary heroin admission rates by State: TEDS 1995-2005
(per 100,000 population aged 12 and over)

Maps comparing Primary heroin admission rates by State in TEDS 1995 to 2005 (per 100,000 population aged 12 and over)

 

 

Figure 5
Primary non-heroin opiates/synthetics admission rates by State: TEDS 1995-2005
(per 100,000 population aged 12 and over)

Maps comparing Primary non-heroin opiates/synthetics admission rates by State in TEDS 1995 to 2005 (per 100,000 population aged 12 and over)

 

 

Figure 6
Primary cocaine admission rates by State: TEDS 1995-2005
(per 100,000 population aged 12 and over)

Maps comparing Primary cocaine admission rates by State in TEDS 1995 to 2005 (per 100,000 population aged 12 and over)

 

 

Figure 7
Primary marijuana admission rates by State: TEDS 1995-2005
(per 100,000 population aged 12 and over)

Maps comparing Primary marijuana admission rates by State in TEDS 1995 to 2005 (per 100,000 population aged 12 and over)

 

 

Figure 8
Primary methamphetamine/amphetamine admission rates by State: TEDS 1995-2005
(per 100,000 population aged 12 and over)

Maps comparing Primary methamphetamine/amphetamine admission rates by State in TEDS 1995 to 2005 (per 100,000 population aged 12 and over)

 

Trends in Demographic Characteristics

Table 2.9b. Males represented 68 percent of TEDS admissions in 2005, a proportion that declined slightly from 71 percent in 1995. The distribution of TEDS admissions by gender was different from that of the U.S. population, where over half (51 percent) of the population was female.

Table 2.9b and Figure 9. The age distribution of TEDS admissions changed between 1995 and 2005. The proportion of TEDS admissions aged 25 to 34 years declined from 36 percent in 1995 to 25 percent in 2005. This decline was offset by overall increases in the proportions of both older and younger admissions. The proportion of older admissions (aged 45 and older) increased from 13 percent in 1995 to 21 percent in 2005. The proportion of younger admissions (less than 25 years of age) increased from 21 percent in 1995 to 26 percent in 2005. (The population of TEDS admissions aged 35 to 44 years remained relatively stable, at between 28 and 33 percent, from 1995 through 2005.)

Figure 9
Age at admission: TEDS 1995-2005

Line chart comparing Age at admission in TEDS 1995 to 2005

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.3.06.

The age distribution of TEDS treatment admissions was different from that of the U.S. population. In 2005, some 88 percent of TEDS admissions were between the ages of 18 and 54, compared to 52 percent of the U.S. population.

Table 2.9b and Figure 10. The racial/ethnic composition of TEDS admissions changed very little between 1995 and 2005. Non-Hispanic Whites made up 58 to 60 percent of admissions throughout the time period. The proportion of non­Hispanic Blacks declined slightly, from 27 percent of admissions in 1995 to 22 percent in 2005. This was offset by increases in the proportions of admissions for Hispanics (from 11 percent in 1995 to 14 percent in 2005) and for other racial/ethnic groups combined (from 4 percent in 1995 to 5 percent in 2005).

Figure 10
Race/ethnicity of admissions: TEDS 1995-2005

Line chart comparing Race/ethnicity of admissions in TEDS 1995 to 2005

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.3.06.

The racial/ethnic composition of TEDS admissions differed from that of the U.S. population. Non-Hispanic Whites were the majority in both groups, but represented 59 percent of TEDS admissions in 2005, compared to 70 percent of the U.S. population. Non-Hispanic Blacks represented 22 percent of TEDS admissions in 2005 and 12 percent of the U.S. population. However, the proportion of Hispanic TEDS admissions (14 percent) was relatively close to the proportion of Hispanics in the U.S. population (12 percent). Other racial/ethnic groups made up 5 percent of TEDS admissions and 6 percent of the U.S. population.

Trends in Socioeconomic Status

Tables 2.10a, 2.10b, and Figures 11 and 12. TEDS admissions aged 16 and over were socioeconomically disadvantaged compared to the U.S. population aged 16 and over. This is evident in the unadjusted distributions of admissions by employment status and education shown in Table 2.10a. Because TEDS admissions differ demographically from the U.S. population, Table 2.10b shows distributions that have been statistically adjusted to provide a more valid comparison to the U.S. population.4 The adjusted distributions indicate an even greater disparity in socioeconomic status than do the unadjusted.

TEDS admissions aged 16 and over were less likely to be employed than the U.S. population aged 16 and over. Some 71 percent (75 percent adjusted) of 2005 TEDS admissions aged 16 and over were unemployed or not in the labor force, compared to 37 percent of the U.S. population aged 16 and over. Only 21 percent (18 percent adjusted) were employed full time, compared to 52 percent of the U.S. population aged 16 and over.

The proportion of TEDS admissions that were employed full time declined from 26 percent in 1995 to 21 percent in 2005. The proportion of TEDS admissions that were unemployed declined from 26 percent in 1995 to a low of 24 percent in 1999 and 2000, but increased to 32 percent by 2005.


4The distributions have been adjusted for age, sex, and race/ethnicity to the U.S. population. In essence, this technique compares the distributions under the assumption that the TEDS population and the U.S. population had the same age, sex, and racial/ethnic characteristics.

Figure 11
Employment status at admission, aged 16 and over: TEDS 1995-2005

Line chart comparing Employment status at admission, aged 16 and over in TEDS 1995 to 2005

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.3.06.

Tables 2.10a, 2.10b, and Figure 12. TEDS admissions aged 18 and over had less education than the U.S. population aged 18 and over. In 2005, some 34 percent (30 percent adjusted) of TEDS admissions aged 18 and over had not completed high school, compared to 16 percent of the U.S. population aged 18 and over. TEDS admissions were also less likely to have received education beyond high school—22 percent (28 percent adjusted) of TEDS admissions aged 18 and over, compared to 52 percent of the U.S. population aged 18 and over. These proportions were relatively stable from 1995 to 2005.

Figure 12
Education at admission, aged 18 and over: TEDS 1995-2005

Line chart comparing Education at admission, aged 18 and over in TEDS 1995 to 2005

SOURCE: Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Treatment Episode Data Set (TEDS). Data received through 10.3.06.

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